The work environments that I have experience with reflect the mixed team co-operative approach. Consequently, the task list does not always cover the needs of the patient. If patient wellbeing is the priority, then the highly motivated nursing team, would likely take a “see it needs to be done, then do it” approach to care falls naturally into place. If it is a skill that is beyond an RPN’s scope of practice, call in the RN. It seems so natural and clear, but from the history, the relationship appears fractured. Perhaps as the new generation of nurses come on board, the history can be changed because health care has changed, and so too has patient acuity & longevity. The RN needs the support and careful work of the RPN now and going forward.
High risk, acuity patient needs are addressed by the RN. However, the RPN assesses, monitors signs and symptoms of discomfort, distress, or that things seem “off” with a patient and then advise the RN of findings and s/sx observed and noted. Documenting observation & findings as well as the details provide to the RN are important.